Carbohydrate Metabolism — MCQs

Carbohydrate Metabolism Indian Medical PG Practice Questions and MCQs

Question 721: In which of the following pathways is UDP glucose not utilized?

A. Uronic acid pathway
B. Glycogen synthesis
C. Galactose metabolism
D. HMP shunt (Correct Answer)

Explanation: ***HMP shunt*** - The **Hexose Monophosphate Shunt (HMP shunt)**, also known as the **pentose phosphate pathway**, primarily uses **glucose-6-phosphate** as its substrate. - Its main products are **NADPH** and **ribose-5-phosphate**, and it does not involve **UDP-glucose**. *Uronic acid pathway* - The **uronic acid pathway** converts **glucose** to **glucuronic acid**, **L-xylulose**, and **ascorbic acid (in some animals)**, utilizing **UDP-glucose** as an intermediate. - Specifically, **UDP-glucose dehydrogenase** oxidizes UDP-glucose to **UDP-glucuronate**. *Glycogen synthesis* - In **glycogen synthesis (glycogenesis)**, **UDP-glucose** is the direct precursor for adding glucose units to the growing **glycogen chain**. - The enzyme **glycogen synthase** catalyzes the transfer of glucose from UDP-glucose to the non-reducing end of glycogen. *Galactose metabolism* - In **galactose metabolism**, **UDP-glucose** plays a crucial role in the conversion of **galactose-1-phosphate** to **glucose-1-phosphate**. - This occurs via the enzyme **galactose-1-phosphate uridyltransferase**, which exchanges UDP from UDP-glucose with the phosphate from galactose-1-phosphate, forming **UDP-galactose** and **glucose-1-phosphate**.

Question 722: Which of the following enzymes do not catalyze an irreversible step in glycolysis?

A. Pyruvate kinase
B. Phosphofructokinase
C. Hexokinase
D. Phosphoglycerate kinase (Correct Answer)

Explanation: ***Phosphoglycerate kinase*** - This enzyme catalyzes the conversion of **1,3-bisphosphoglycerate** to **3-phosphoglycerate**, generating ATP. - This reaction is considered reversible because the free energy change is close to zero under physiological conditions, allowing for both forward (glycolysis) and reverse (gluconeogenesis) flux. *Hexokinase* - This enzyme catalyzes the **irreversible phosphorylation** of glucose to glucose-6-phosphate, trapping glucose within the cell. - It is one of the key regulatory enzymes in glycolysis, and its irreversibility ensures that glucose uptake and phosphorylation proceed in one direction. *Pyruvate kinase* - This enzyme catalyzes the final, **irreversible step** of glycolysis, converting phosphoenolpyruvate to pyruvate and generating ATP. - This reaction is a major control point for glycolysis due to its large negative free energy change. *Phosphofructokinase* - This enzyme catalyzes the **irreversible phosphorylation** of fructose-6-phosphate to fructose-1,6-bisphosphate. - It is considered the **rate-limiting step** and a primary control point in glycolysis, making it highly regulated and unidirectional.

Question 723: Which of the following steps is specific for gluconeogenesis?

A. Oxaloacetate to PEP (Correct Answer)
B. Oxaloacetate to citrate
C. Oxaloacetate to glucose
D. Pyruvate to acetyl CoA

Explanation: ***Oxaloacetate to PEP*** - This step, catalyzed by **PEP carboxykinase (PEPCK)**, is a bypass reaction necessary to overcome the irreversible pyruvate kinase step in glycolysis. - It is a key regulatory point in **gluconeogenesis**, allowing the synthesis of glucose from non-carbohydrate precursors. *Oxaloacetate to citrate* - This reaction is part of the **Krebs cycle (citric acid cycle)**, where oxaloacetate combines with acetyl-CoA to form citrate. - It does not directly lead to **glucose synthesis** and is not unique to gluconeogenesis. *Oxaloacetate to glucose* - This is an **overly broad statement** and not a direct, single enzymatic step in gluconeogenesis. - While oxaloacetate is an intermediate in the gluconeogenic pathway, it must first be converted to **PEP** and then proceed through several more steps to become glucose. *Pyruvate to acetyl CoA* - This reaction is catalyzed by the **pyruvate dehydrogenase complex** and represents a committed step into oxidative metabolism, primarily the Krebs cycle. - This step is **irreversible** in mammals and prevents the direct conversion of acetyl-CoA back to pyruvate or glucose, making it not relevant for gluconeogenesis.

Question 724: Which of the following is an aldose sugar?

A. Ribulose
B. Fructose
C. Glyceraldehyde (Correct Answer)
D. None of the options

Explanation: ***Glyceraldehyde*** - **Glyceraldehyde** is the simplest **aldose**, a monosaccharide with an **aldehyde group** (CHO) at one end of its carbon chain. - Its chemical structure is a three-carbon chain with the aldehyde group on the first carbon, making it an **aldo sugar**. *Ribulose* - **Ribulose** is a **ketose**, specifically a **ketopentose**, meaning it is a five-carbon sugar with a **ketone group** (C=O) in its structure. - The ketone group in ribulose is typically located on the second carbon, distinguishing it from aldoses. *Fructose* - **Fructose** is another example of a **ketose**, specifically a **ketohexose**, as it is a six-carbon sugar containing a **ketone group**. - Its ketone group is usually found on the second carbon atom, which differentiates ketoses from aldoses structurally. *None of the options* - This option is incorrect because **glyceraldehyde** is indeed an aldose sugar, fitting the definition of a monosaccharide with an aldehyde functional group. - As **glyceraldehyde** is correctly identified as an aldose, this choice would contradict the chemical classification of sugars.

Question 725: Which enzyme converts glucose to sorbitol?

A. Sorbitol dehydrogenase
B. Aldose reductase (Correct Answer)
C. Aldolase B
D. Glucose-6-phosphate dehydrogenase

Explanation: ***Aldose reductase*** - This enzyme is crucial in the **polyol pathway**, reducing **glucose to sorbitol** by using **NADPH** as a cofactor. - In conditions of high glucose (e.g., uncontrolled diabetes), increased activity of **aldose reductase** leads to sorbitol accumulation, contributing to **osmotic damage** in certain tissues like the lens, nerves, and kidneys. *Sorbitol dehydrogenase* - This enzyme is responsible for the subsequent step in the polyol pathway, **oxidizing sorbitol to fructose** using NAD+ as a cofactor. - While related to sorbitol metabolism, it does not convert glucose to sorbitol; instead, it metabolizes sorbitol further. *Aldolase B* - This enzyme is involved in **fructose metabolism**, specifically cleaving **fructose-1-phosphate** into **dihydroxyacetone phosphate** and **glyceraldehyde**. - It plays no direct role in the conversion of glucose to sorbitol. *Glucose-6-phosphate dehydrogenase* - This is the rate-limiting enzyme of the **pentose phosphate pathway**, catalyzing the oxidation of glucose-6-phosphate to 6-phosphoglucono-δ-lactone. - While it also uses NADPH (producing it rather than consuming it), it is not involved in the polyol pathway or sorbitol synthesis.

Question 726: Insulin resistance down-regulates the translocation of which glucose transporter to the cell membrane?

A. GLUT-1
B. GLUT-2
C. GLUT-3
D. GLUT-4 (Correct Answer)

Explanation: ***GLUT-4*** - **Insulin resistance** primarily affects cells that express **GLUT-4**, such as muscle and adipose tissue, by impairing its translocation from intracellular vesicles to the cell membrane. - This reduced translocation leads to decreased glucose uptake in response to insulin, a hallmark of **type 2 diabetes**. *GLUT-1* - **GLUT-1** is responsible for basal glucose uptake in nearly all cells, including **erythrocytes** and endothelial cells of the blood-brain barrier. - Its activity is largely **insulin-independent** and not significantly affected by insulin resistance in the same way as GLUT-4. *GLUT-2* - **GLUT-2** is found primarily in **pancreatic β-cells**, hepatocytes, renal tubular cells, and enterocytes. - It has a low affinity but high capacity for glucose transport, playing a key role in **glucose sensing** and facilitating glucose flux in and out of these cells, independent of insulin translocation. *GLUT-3* - **GLUT-3** is predominantly expressed in **neurons** and the placenta, where it facilitates high-affinity glucose uptake. - It is crucial for maintaining the brain's glucose supply and its activity is also **insulin-independent**.

Question 727: Which of the following dietary fibers is most characteristically insoluble in water?

A. Pectin
B. Lignin (Correct Answer)
C. Hemicellulose
D. Cellulose

Explanation: ***Lignin*** - **Lignin** is a complex polymer found in plant cell walls, known for its **extreme insolubility** in water. - It provides structural rigidity to plants and is a non-carbohydrate component of **dietary fiber**. *Pectin* - **Pectin** is a type of soluble dietary fiber that forms a **gel-like substance** when mixed with water. - It is often used as a gelling agent in foods and is found in fruits like apples and citrus. *Hemicellulose* - **Hemicellulose** is a diverse group of polysaccharides; some forms are **soluble**, while others are **insoluble**, but it's generally more soluble than lignin. - Its solubility depends on its specific structure and sugar composition. *Cellulose* - **Cellulose** is an insoluble fiber, but it can absorb water and swell, contributing to **bulk in stool**. - While largely insoluble, **lignin** is considered the most characteristically insoluble fiber due to its highly cross-linked and rigid structure, which resists hydration even more effectively than cellulose.

Question 728: An adolescent male patient presents to you with exercise intolerance. He gives a history of developing cramps on exertion. Which of the following enzyme deficiencies could be the cause?

A. Myophosphorylase (Correct Answer)
B. Hexokinase
C. Glucose-6-phosphatase
D. Hepatic glycogen phosphorylase

Explanation: ***Myophosphorylase*** - A deficiency in **myophosphorylase** (McArdle's disease, Glycogen Storage Disease Type V) impairs muscle glycogen breakdown, leading to **exercise intolerance** and **muscle cramps** due to insufficient ATP production during exertion. - Patients often experience a "second wind" phenomenon where symptoms improve after resting, as free fatty acids become an alternative fuel source. *Hexokinase* - A deficiency in **hexokinase** would affect the first step of glycolysis, impacting glucose phosphorylation in all tissues, not specifically causing exercise-induced muscle cramps. - This deficiency is rare and typically presents with **hemolytic anemia** due to impaired erythrocyte metabolism. *Glucose-6-phosphatase* - A deficiency in **glucose-6-phosphatase** (Von Gierke's disease, Glycogen Storage Disease Type Ia) primarily affects the liver and kidneys, leading to **fasting hypoglycemia**, lactic acidosis, and hepatomegaly, not exercise intolerance. - Muscle glycogen metabolism is unaffected in this condition. *Hepatic glycogen phosphorylase* - A deficiency in **hepatic glycogen phosphorylase** (Hers' disease, Glycogen Storage Disease Type VI) mainly causes **hepatomegaly** and **mild hypoglycemia** because the liver cannot effectively mobilize its glycogen stores. - **Muscle glycogen metabolism** remains normal, so exercise intolerance and cramps are not characteristic symptoms.

Question 729: When the insulin to glucagon ratio decreases, which enzyme is primarily active?

A. Glucose-6-phosphatase
B. Pyruvate carboxylase
C. Fructose 1,6-bisphosphatase
D. Glycogen phosphorylase (Correct Answer)

Explanation: ***Glycogen phosphorylase*** - A decrease in the **insulin-to-glucagon ratio** indicates a **low blood glucose** state, signaling the need for glucose production. - **Glycogen phosphorylase** is the key enzyme in **glycogenolysis**, which breaks down stored glycogen into glucose-1-phosphate, thereby elevating blood glucose. - This is the **primary and fastest response** to decreased insulin/glucagon ratio. *Fructose-1,6-bisphosphatase* - This enzyme is crucial for **gluconeogenesis**, specifically catalyzing the dephosphorylation of **fructose-1,6-bisphosphate** to **fructose-6-phosphate**. - While active during low insulin/high glucagon states, it is involved in synthesizing glucose, not directly breaking down stored glycogen as quickly as glycogen phosphorylase. *Pyruvate carboxylase* - This enzyme is the first committed step in **gluconeogenesis**, converting **pyruvate to oxaloacetate** in the mitochondria. - Although active in response to a low insulin-to-glucagon ratio, its role is in synthesizing glucose from non-carbohydrate precursors, which is a slower process than immediate glycogen breakdown. *Glucose-6-phosphatase* - This enzyme is found primarily in the **liver and kidneys** and is responsible for dephosphorylating **glucose-6-phosphate** to free glucose, allowing it to exit the cell into the bloodstream. - While essential for the release of glucose from both gluconeogenesis and glycogenolysis, it acts at a later stage to make glucose available rather than initiating the breakdown of glycogen itself.

Question 730: Classical galactosemia (Type I) is due to deficiency of which enzyme?

A. Galactose-1-phosphate uridyltransferase (Correct Answer)
B. Fructose-1,6-bisphosphatase
C. Adenine phosphoribosyltransferase (APRT)
D. Hexokinase

Explanation: ***Galactose-1-phosphate uridyltransferase*** - **Galactosemia Type I** (**classical galactosemia**) is caused by a deficiency in **galactose-1-phosphate uridyltransferase (GALT)**. - This enzyme is crucial for converting **galactose-1-phosphate** to **glucose-1-phosphate** in the Leloir pathway of galactose metabolism. *Adenine phosphoribosyltransferase (APRT)* - Deficiency in **adenine phosphoribosyltransferase (APRT)** leads to **APRT deficiency**, characterized by **kidney stones** composed of 2,8-dihydroxyadenine. - This enzyme is involved in **purine salvage pathways**, not carbohydrate metabolism. *Fructose-1,6-bisphosphatase* - A deficiency in **fructose-1,6-bisphosphatase** causes **fructose-1,6-bisphosphatase deficiency**, a disorder of **gluconeogenesis**. - It results in **hypoglycemia** and **lactic acidosis**, especially during fasting. *Hexokinase* - **Hexokinase** phosphorylates glucose to **glucose-6-phosphate**, the first step in glycolysis. - Deficiency is rare but can lead to **nonspherocytic hemolytic anemia**.

Practice by Chapter

Carbohydrate Chemistry and Classification

Practice Questions

Glycolysis: Reactions and Regulation

Practice Questions

Gluconeogenesis: Reactions and Regulation

Practice Questions

Glycogen Metabolism: Synthesis and Breakdown

Practice Questions

Glycogen Storage Diseases

Practice Questions

Pentose Phosphate Pathway

Practice Questions

Metabolism of Fructose and Galactose

Practice Questions

Disorders of Fructose and Galactose Metabolism

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Blood Glucose Regulation

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Diabetes Mellitus: Biochemical Aspects

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Glycosylation and Glycoproteins

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Lactose Intolerance and Galactosemia

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